V11-05 MONOCENTRIC EXPERIENCE OF ROBOT-ASSISTED RADICAL NEPHRECTOMY WITH VENA CAVA THROMBECTOMY: TECHNIQUE AND RESULTS

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You have accessJournal of UrologyRenal Oncology II (V11)1 Sep 2021V11-05 MONOCENTRIC EXPERIENCE OF ROBOT-ASSISTED RADICAL NEPHRECTOMY WITH VENA CAVA THROMBECTOMY: TECHNIQUE AND RESULTS Louis Gobinet, Lorenzo Tesi, Nam Son Vuong, Melanie Percot, Laure Dupitout, Helene Simeon, Eric Alezra, Franck Bladou, Gregoire Robert, Marine Gross Goupil, and Jean Christophe Bernhard Louis GobinetLouis Gobinet More articles by this author , Lorenzo TesiLorenzo Tesi More articles by this author , Nam Son VuongNam Son Vuong More articles by this author , Melanie PercotMelanie Percot More articles by this author , Laure DupitoutLaure Dupitout More articles by this author , Helene SimeonHelene Simeon More articles by this author , Eric AlezraEric Alezra More articles by this author , Franck BladouFranck Bladou More articles by this author , Gregoire RobertGregoire Robert More articles by this author , Marine Gross GoupilMarine Gross Goupil More articles by this author , and Jean Christophe BernhardJean Christophe Bernhard More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002073.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Open surgery remains the gold standard treatment for renal tumours with thrombus extension of the inferior vena cava (IVC), whereas the robotic approach has been developed by some expert teams. Two comparative studies are available in the literature. This video’s objective was to present the technique and results of robot-assisted radical nephrectomy with IVC thrombectomy. METHODS: We described the surgical technique of the robotic approach, carried out with the Da-Vinci SI (Intuitive Surgical) surgical robot and intra-operative ultrasound (Hitachi). We present the results of the comparative monocentric retrospective study, which included patients undergoing a radical nephrectomy with IVC thrombus from level 1 to 3 (Mayo clinic classification), between December 2015 and December 2019. Clinical data, collected after consent, come from the prospective French kidney cancer data base UroCCR (CNIL DR 2013-206, NCT03293563). Patients were divided into 2 groups, according to the surgical approach, open or robotic. We present univariate and multivariate analysis of perioperative morbidity and oncological findings. RESULTS: The patient, an 81-year-old man, presented an 8cm tumour of the upper and mid-pole of the right kidney, associated with a thrombus of the IVC. The CT-scan for extension work-up was negative. Operative time (OT) was 320 minutes, including 24 minutes of IVC clamping, with 300cc of blood loss. The length of hospital stay (LOS) was 4 days. Pathology report showed a Clear cell renal carcinoma, Fuhrman grade 4, pT3cN0M0.The open-approach group included 30 patients and the robotic group 10 patients. OT was significantly longer in the robotic group (350 vs 208 min (p<0.01) while blood loss (500 vs 1250 mL (p=0.02)) and LOS (7 Vs 10 days (p<0.01) were reduced. There was no significant difference in terms of postoperative complications or oncological results. CONCLUSIONS: The robotic approach for radical nephrectomy with IVC thrombectomy appears to be feasible and safe, for selected patients in expert centers. It leads to longer operative times, but reduced blood loss and shorter length of stay. Source of Funding: none © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e859-e859 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Louis Gobinet More articles by this author Lorenzo Tesi More articles by this author Nam Son Vuong More articles by this author Melanie Percot More articles by this author Laure Dupitout More articles by this author Helene Simeon More articles by this author Eric Alezra More articles by this author Franck Bladou More articles by this author Gregoire Robert More articles by this author Marine Gross Goupil More articles by this author Jean Christophe Bernhard More articles by this author Expand All Advertisement Loading ...